B.M.A. Criticises Social Security Plan; Warning Sounded

Northern Advocate, 11 August 1938, Page 8

B.M.A. Criticises Social Security Plan; Warning Sounded

[Per Press Association. Copyright,] WELLINGTON, This Day

AN OFFICIAL STATEMENT ON THE NATIONAL HEALTH INSURANCE " SCHEME WAS ISSUED YESTERDAY BY THE NEW ZEALAND BRANCH OF THE BRITISH MEDICAL ASSOCIATION. “The first point the British Medical Association wishes to stress,” says the statement, “is that the whole desire for a universal health insurance scheme in New Zealand appears to arise from a politico-social conception, rather from a consideration of the practical necessities, or in other words, from a desire to copy the provisions made in other countries, while almost totally overlooking the very much better conditions that already exist in this country, and have existed for many years. Unchangeable proof of this fact exists in the health statistics, in which New Zealand compares more than favourably with those of any other country in the world.

Starting on Wrong Lines. “Secondly, it appears that the Government. actuated by this politicosocial conception, is starting out on altogether wrong lines by ignoring the principle that prevention is better than cure, and that far more can be done for the improvement of the general health of the people of the Dominion by this means than by assuming that the provision of universal “free” treatment for the cure of disease after it has occurred will prove to be an effective measure for the reduction of sickness. Results of Experience. “Understanding that the motive of the Government in embarking upon the proposed legislation is to raise the health standard of the community and to make treatment more available, •'Where required, the British Medical Association has pointed out that the experience of countries which had had systems in operation from 20 to 50 years is that national health insurance. ' as such, and in itself, has not had appreciable or measurable effect in reducing the incidence and volume of sickness. This is because all systems so far in operation have been directed almost wholly to the treatment of disease after it has occurred. While those systems have been of service to their beneficiaries in securing treatment previously unavailable, they have proved disappointing in their reduction of disease. This is in' sharp contrast to the application of preventive medicine, which, in the same period, has achieved outstanding and definite results in many fields. Curative Medicine Available.* “It is the recommendation of the , profesison that the greatest possible provision should be made for the elimination of known sources of disease and unfitness, the investigation of unknown causes of these, and co-opera-tion between the branches of preven-' tive and curative medicines. Curativemedicine in this country is singularly Well provided for, and it is urged that a strongly preventive trend should be given to the legislation contemplated. During the sitting of the Select Committee, the Hon. W. Nash said that preventive measures ‘were not an alternative.’ If remaining well be not a good" alternative to requiring treatment for fitness, it is hard to see what could be called an alternative.

Different Conditions.

“In the countries in which health insurance has come to be a considerable factor in medical service, there are large masses of dense industrial population on low wages, for whose medical treatment insufficient provision was made, and who, even when employed, could not make . effective provision for themselves. On these points, conditions are markedly different in New Zealand. We have neither the large proportion of industrial workers nor density of population; and, in employment, wages are such that, along with various types of assistance provided, treatment is very rarely unavailable. Further, the scattered nature of our population must make pur adoption of national health insurance relatively costly. “In the countries which have adopted the insurance principle, public pre - vision for curative medicine was at the time very limited, and greatly below the requirements of their population. This was a reason urging its introduction. This is not so in New Zealand* In no other country in the world 'are the requirements of curative medicine so literally and generally provided as here. One Needy Class. ,‘Tn the opinion of the association, the necessities and responsibilities of treatment are being fairly met, excepting at one point, and that is in respect to those unable to make adequate prevision for medical treatment, especially the unemployed, disabled and aged poor, where treatment and care of a hospital character are required in their own homes. The association submits that it is only for this group that provision for treatment beyond those already existing is required. “This requirement will be most effectively met by placing at the disposal of this group domicilary medical attendants of their own choice, and nursing services, where required, to the end that they may receive the same advantages as other members of the community. “The standard of medical practice in New Zealand is unquestionably high, and New Zealand at the present

moment has a quality of medical service better adapted to requirements than that provided under any national insurance system elsewhere. Is this :o be wrecked? If the bill is enacted in iis present form, the British Medical Association, has no hesitation in declaring that the present efficiency will be gravely endangered, and that any measure which does that, must operate prejudicially to the general health cf the people of New Zealand. Contract System Deprecated. “This association deprecates the introduction of a system of contract practice on an extensive scale, which would result in practioners*relying for a great part of the substance on it, and knows that such a system would not be appreciated by the public, long accustomed to a personal type of medical service, free from the regulations and restrictions inseparable from an insurance system. “It is for these reasons that the association has recommended a restricted scheme which fills a need and disturbs as little as maybe the system which has grown up over a period approaching a century, in response to the special requirements of this country, and has justified itself by showing statistics of general mortality, infantile mortality, and longevity which for years has been unsurpassed.” '